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Shocking Science Around The Placebo Effect

According to new research, the placebo effect is about more than just sugar pills. In fact, recent studies suggest that placebos may be effective in treating a number of medicalconditions. Several recent studies have found that a patient’s mind-set or belief may lead to improvements in disease symptoms as well as changes in appetite or brain chemicals.

We found an intriguing story from the Wall Street Journalwith some examples supporting this strong mind-body connection. What’s surprising is, it doesn’t seem to matter whether people know they are getting a placebo instead of a “real” treatment. One study demonstrated a strong placebo effect in subjects who were told they were getting a sugar pill with no active ingredient.

Some examples:

Hotel-room attendants who were told they were getting a good workout at their jobs showed a significant decrease in weight, blood pressure and body fat after four weeks. Employees who did the same work but weren’t told about exercise showed no change in weight. Neither group reported changes in physical activity or diet.

After drinking a milkshake, people’s feelings of satisfaction depended on how many calories they thought they consumed rather than how many they actually consumed. Ghrelin is a gut peptide that tells the body when it is hungry or satisified, and ghrelin levels are supposed to rise when the body needs food and fall proportionally as calories are consumed. But the ghrelin levels of study participants who were told the milkshake they were about to drink had 620 calories fell significanlty more than the levels of those who were told the shake had 120 calories.

A study published in Science found that placebo was effective at improving Parkinson’s disease symptoms at a magnitude similar to real medication. The placebo actually induced the brain to produce greater amounts of dopamine, the neurotransmitter known to be useful in treating the disease.

As noted earlier, deception isn’t necessary for the placebo effect to work. Patients with irritable bowel syndrome, a chronic gastrointestinal disorder, were assigned either a placebo or no treatment. Patients in the placebo group got pills described to them as being made with an inert substance and showing in studies to improve symptoms via “mind-body self-healing processes.” Participants were told they didn’t have to believe in the placebo effect but should take the pills anyway.

After three weeks, placebo-group patients reported feelings of relief, significant reduction in some symptoms and some improvement in quality of life. According to Ted Kaptchuk, director of Harvard’s Program in Placebo Studies and the Therapeutic Encounter, expectations play a role. Also, patients were conditioned to a positive environment, and the innovative approach and daily ritual of taking the pill may have created an openness to change.

Sometimes a placebo can even be more effective than the intended treatment. In one trial, women who had menopausal hot flashes got either five weeks of real acupuncture, or five weeks of sham acupuncture, where needles weren’t placed in accepted therapeutic positions. A week after treatments ended, only about 60 percent of participants in both groups reported hot flashes. Seven weeks post-treatment, however, 55 percent of patients in the sham acupuncture group reported having hot flashes, compared with 73 percent in the real acupuncture group.

So, do placebos work on the actual condition, or on patients’ perception of their symptoms? According to Dr. Kaptchuk: “Right now, I think evidence is that placebo changes not the underlying biology of an illness, but the way a person experiences or reacts to an illness.”

In many cases the side effects of a medication clue people in clinical trials that they are on the “real” drug being tested and that alone often improves outcomes.

If people think their depression is triggered by a chemical imbalance — and that it can be corrected by taking a drug — they may be more likely to seek care, an action that by itself can reduce stress and, thus, improve mood.